Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Radiology, Guangxi International Zhuang Medical Hospital, Nanning, China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2351196. doi: 10.1080/14767058.2024.2351196. Epub 2024 May 12.
Although early evidence shows that epilepsy can increase the risks of adverse pregnancy, some outcomes are still debatable. We performed a systematic review and meta-analysis to explore the effects of maternal and fetal adverse outcomes in pregnant women with epilepsy.
PubMed, Embase, Cochrane, and Web of Science were employed to collect studies that investigated the potential risk of obstetric complications during the antenatal, intrapartum, or postnatal period, as well as any neonatal complications. The search was conducted from inception to November 16, 2022. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included original studies. The odds ratio (OR) values were extracted after adjusting for confounders to measure the relationship between pregnant women with epilepsy and adverse maternal or fetal outcomes. The protocol for this systematic review is registered with PROSPERO ID CRD42023391539.
Of 35 articles identified, there were 142,577 mothers with epilepsy and 34,381,373 mothers without epilepsy. Our study revealed a significant association between pregnant women with epilepsy (PWWE) and the incidence of cesarean section, preeclampsia/eclampsia, gestational hypertension, induction of labor, gestational diabetes and postpartum hemorrhage compared with those without epilepsy. Regarding newborns outcomes, PWWE versus those without epilepsy had increased odds of preterm birth, small for gestational age, low birth weight (<2500 g), and congenital malformations, fetal distress. The odds of operative vaginal delivery, newborn mortality, and Apgar (≤ 7) were similar between PWWE and healthy women.
Pregnant women affected by epilepsy encounter a higher risk of adverse obstetric outcomes and fetal complications. Therefore, it is crucial to develop appropriate prevention and intervention strategies prior to or during pregnancy to minimize the negative impacts of epilepsy on maternal and fetal health.
尽管早期证据表明癫痫会增加不良妊娠的风险，但某些结果仍存在争议。我们进行了系统评价和荟萃分析，以探讨癫痫孕妇的母婴不良结局。
我们使用 PubMed、Embase、Cochrane 和 Web of Science 收集了研究癫痫孕妇在产前、产时或产后期间产科并发症潜在风险的研究。检索时间从建库至 2022 年 11 月 16 日。使用纽卡斯尔-渥太华量表（NOS）评估纳入原始研究的质量。在调整混杂因素后提取比值比（OR）值，以衡量癫痫孕妇与不良母婴结局之间的关系。本系统评价的方案已在 PROSPERO 注册，注册号为 CRD42023391539。
在 35 篇文章中，有 142577 名癫痫孕妇和 34381373 名无癫痫孕妇。我们的研究表明，与无癫痫孕妇相比，癫痫孕妇发生剖宫产、子痫前期/子痫、妊娠期高血压、引产、妊娠期糖尿病和产后出血的风险显著增加。就新生儿结局而言，癫痫孕妇与无癫痫孕妇相比，早产儿、小于胎龄儿、低出生体重（<2500g）和先天性畸形、胎儿窘迫的风险更高。癫痫孕妇与健康女性的经阴道分娩、新生儿死亡率和 Apgar（≤7）评分的风险相似。
患有癫痫的孕妇面临更高的不良产科结局和胎儿并发症风险。因此，在怀孕前或怀孕期间制定适当的预防和干预策略至关重要，以尽量减少癫痫对母婴健康的负面影响。
